| NPI | 1326091612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISABETH PESCE Secretary 904-605-4986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NC MHL 092-495) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2023-02-07 |